Friday 10th November 2023
Last week, Heart Valve Voice held an Evidence Roundtable on HMS Belfast featuring patients, clinicians, industry representatives and key opinion leaders from the health and patient advocacy space. We were asked to do this by the All-Party Parliamentary Group for Heart Valve Disease, who wanted to understand the current challenges in the patient pathway, as well as the ideas and innovations that can unlock those barriers.
The discussion was centred around three topics:
- Delivering Early Detection
- Improving Access to Treatment, and
- Increasing Treatment Capacity
With clinical representatives from across the pathway, the first section saw Dr Yassir Javaid outline the current state of play for valve disease in Primary Care. Yassir articulated the challenges GPs face in detecting the disease, stressing the importance of ensuring that valve disease is taken seriously in primary care. Yassir was of the opinion that valve disease is often not given the priority it deserves compared to other comorbidities. Advanced Clinical Pharmacist Nirali Sisodia discussed the potential for pharmacy to play a part with the aid of innovative technology. Nirali highlighted that pharmacists are a trusted, pre-existing touchpoint that could be utilised to improve detection with the support of digital stethoscopes that can listen with greater accuracy.
What was clear was that we need to find a way to deliver symptom-specific community detection, a system which ensures that anyone who feels breathless has access to a stethoscope check. This needs to be coupled with a collaborative awareness campaign endorsed by the Government and the NHS around the symptoms of heart valve disease.
On access to treatment, we heard from Dr Clare Appleby, who recently co-authored a paper on inequalities in access to valve treatment based on gender, ethnicity and socio-economic status. Clare outlined the results of her research, as well as some potential solutions, including gender-specific pathways and greater representation in clinical trials. Mark Grumbridge from the MHRA echoed this call and said that more needs to be done to ensure trials and research groups are representative.
We ended our discussion with increasing treatment capacity. Dr Jon Byrne from Valve for Life and Dr Douglas Muir discussed how levels can and should be increased for all treatment options. Douglas highlighted how his centre has developed a streamlined single point-of-access service, which has enhanced the service for patients. He also highlighted the importance of good-quality referrals and their role in speeding up decision-making at MDTs. Jon stressed the need for a fast-track pathway for aortic stenosis, a sentiment echoed by the rest of the group. This pathway gives centres a measurable benchmark, and while it will not necessitate a perfect system, it will be a huge point of progress in treating heart valve disease.
Together with Professor Huon Gray, Heart Valve Voice will now write an action plan based on the evidence given. This will have clear and measurable goals, which, with the support of the APPG, our clinical stakeholders, the patient community and industry supporters, we will work to deliver over the next 12 months. This was a valuable discussion, and on behalf of Heart Valve Voice’s patient community, I would like to thank all the participants for contributing their time and expertise.